Bidding Affidavit Form (For A Late Renewal) - Exception printable pdf download

BIDDING AFFIDAVIT

(FOR A LATE RENEWAL)

Please answer the following question:

Yes__ No__

Have you bid, contracted, or performed any work that would require an Arkansas

Contractors License since the license expired?

*If No, sign the affidavit and have it notarized by a Notary Public.

*If Yes, complete the exception box below, sign and have it notarized by a Notary

Public.

******************************************************************************************

Exception

Complete only if you have bid, contracted, or performed any work that requires an Arkansas Contractors

License since the license expired. If necessary, attach additional sheet(s).

List the project(s) name, address, date started, and dollar amount:

_________________________________________________________________________________

***NOTE TO COMMERICAL CONTRACTORS***

This affidavit does not apply to bids offered to the Arkansas State Highway Department for work on

Federal Aid Highway projects.

AFFIDAVIT

I _______________________________, being duly sworn/affirmed, state under oath: that,

(Name of officer, owner, partner, or member)

I am an\a ___________________________ of ____________________________________

(Title: Officer, owner, partner, or member)

(Name of company\entity as it appears on license)

the applicant herein; that the applicant has not bid, contracted or performed any work in

Arkansas which would require a contractor’s license since it expired on ________________

(Expiration date of license)

and said applicant will not bid, contract, or perform any such work until the license has been

renewed/reinstated.

I have read and understand the information above.

__________________________________________

(Signature of officer, owner, partner, or member)

STATE OF ______________________________COUNTY/PARISH________________________________

Sworn/Affirmed to before me this ________day of ______________________________, 20____.

_____________________________________________

(Notary public’s signature and stamp/seal)

The Affidavit must be answered truthfully. The submission of an incomplete or false affidavit constitutes fraud

or deceit in obtaining a license and could result in the revocation of your license.

Revised 04/2012

Bidding Affidavit Form (For A Late Renewal) - Exception